Diabetes education and health insurance: How they affect the quality of care provided to people with type 1 diabetes in Latin America. Data from the International Diabetes Mellitus Practices Study (IDMPS)

Diabetes Res Clin Pract. 2019 Jan:147:47-54. doi: 10.1016/j.diabres.2018.08.007. Epub 2018 Aug 15.

Abstract

Aims: This study aimed to evaluate the impact of diabetes education and access to healthcare coverage on disease management and outcomes in Latin America.

Methods: Data were obtained from a sub-analysis of 2693 patients with type 1 diabetes mellitus recruited from 9 Latin American countries as part of the International Diabetes Mellitus Practices Study (IDMPS), a multinational, observational survey of diabetes treatment in developing regions.

Results: Results from the Latin American cohort show that only 25% of participants met HbA1c target value (< 7% [53 mmol/mol]). Attainment of this target was significantly higher among participants who had received diabetes education than those who hadn't (28% vs. 19%, p < 0.001), and among those who practiced self-management (27% vs. 21% no self-management, p = 0.001). Multivariate analysis showed that participants who had received diabetes education were more likely to manage their diabetes (OR:1.65 [95% CI: 1.24, 2.19]; p = 0.001), and to attain HbA1c target values (OR:1.48 [95% CI: 1.14, 1.93]; p = 0.003).

Conclusions: Given the association between uncontrolled diabetes and long-term complications, health authorities and care providers should increase efforts to ensure widespread healthcare coverage and access to self-management education to reduce the socioeconomic and humanistic burden of type 1 diabetes.

Keywords: Diabetes education; Management; Observational study; Treatment; Type 1 diabetes mellitus.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetes Mellitus, Type 1 / therapy*
  • Female
  • Health Education / methods*
  • Humans
  • Insurance, Health / standards*
  • Latin America
  • Male
  • Quality of Health Care / standards*